Counseling minors: legal issues

Who signs the consent form when your client is eight years old? Not the child — and that single fact opens up the whole legal puzzle of counseling minors, a puzzle examiners love because two words, consent and assent, look alike but mean opposite things.

Consent vs. assent. A minor usually cannot give legally binding informed consent — that authority belongs to the parent or legal guardian. What the child gives is assent: their developmentally appropriate agreement to participate. Best practice secures parental consent AND the minor's assent. Consent is the legal authorization; assent is the ethical buy-in.

Custodial rights. Only a parent with legal custody may consent to and access the minor's treatment. In divorce/separation cases, the counselor must know who holds legal (decision-making) custody — which is distinct from physical custody. Verify custody documents; a non-custodial parent may lack the right to consent or to records.

Confidentiality with parents. Legally, parents often have the right to information about their minor child's counseling, which can collide with the child's therapeutic need for privacy. The recommended approach: at the outset, clarify confidentiality expectations with both parents and child, negotiating what will and won't be shared. Counselors work to protect the minor's confidences while respecting parents' legal rights — and always disclose when safety (harm to self/others, abuse) is at stake.

Exceptions. Many states let minors consent on their own for specific services (e.g., substance use, reproductive, or mental-health care under certain ages) — statutes vary by jurisdiction.

Clinical Pearl: Parents/guardians give consent (the legal authorization); the minor gives assent (developmentally appropriate agreement) — and confirm who holds legal custody before proceeding, since only that parent may consent and access records.